Continuous lavage with voriconazole CONTROLS progression in moderate and severe fungal keratitis

This study is published in Graefe's Archive for Clinical and Experimental Ophthalmology.

It is already known that continuous lavage with antibiotics is proven to be SUCCESSFUL for managing resistant bacterial keratitis. This is because it increases the drug concentration in the cornea.

The main purpose of this study was to assess the effectiveness and safety of continuous lavage with 1% voriconazole (CL) for moderate and severe fungal keratitis.

The researchers randomized thirty-one patients receiving topical eye drops either alone (T) or combined with continuous 1% voriconazole lavage (CL-T) and measured the cure rate at three months as the primary outcomes.

The secondary outcomes were the 6-day efficacy, 3-day infiltration size and depth, hypopyon height, central corneal thickness (CCT), epithelial defect size, and subject feelings and clinical signs assessment scores.

At three months, the cure rate was comparable between the groups in patients with moderate fungal keratitis (66.7% vs 62.5%). Nearly four cases constituting 44.4 %, are the severe cases in the CL-T group healed successfully, while none in the T group; this difference was insignificant (small sample size).

After six days, the percentage of patients with "worsened" ulcers in the CL-T group was lower when compared to that of the T group, recorded as 0% vs 31%.

After three days, the infiltration size, infiltration depth, and hypopyon height in the CL-T group were smaller than in the T group. There was no difference between groups in CCT, epithelial defect size, subject feelings scores, or clinical signs scores.

They said, "In our research, we found that CL is an effective and safe adjuvant method for controlling the progression of moderate and severe fungal keratitis."

Further reading:

https://link.springer.com/article/10.1007/s00417-022-05969-z